青春期多囊卵巢综合征患者内分泌、代谢紊乱特征分析

Analysis of the character of reproductive endocrine and metabolic abnormalities in adolescent girls with polycystic ovary syndrome

目的:探讨青春期多囊卵巢综合征(PCOS)患者的内分泌及代谢紊乱特征。方法:青春期PCOS患者87例(PCOS组),其中52例体重指数(BMI)≥25 kg/m2或腰臀比(WHR)≥0.85者为肥胖组(OB-PCOS);35例BMI<25 kg/m2,WHR<0.85者为非肥胖组(NOB-PCOS)。正常对照组102例,为月经正常的中学生,同样分为肥胖组(OB-CON)22例,非肥胖组(NOB-CON)80例。所有对象均测定睾酮(T)、促黄体生成素(LH)、泌乳素(PRL)、促黄体生成素/促卵泡激素(LH/FSH)比值、空腹胰岛素及稳态模型指数(HOMA-IR)、空腹血糖、血脂,测定人BMI及WHR,记录月经史。结果:对照组初潮年龄为(13.0±1.3)岁,96%在初潮后2年内建立规律月经。PCOS组初潮年龄为(12.0±1.5)岁,86%的患者在2年内未能建立规律月经。PCOS组肥胖发生率显著高于对照组(P<0.01)。PCOS组血清T、LH、PRL、LH/FSH比值、空腹FINS、HOMA-IR、TC、TG及BMI、WHR均显著高于对照组(P<0.01),并且OB-PCOS组高于NOB-PCOS(P<0.05)。96.3%PCOS患者卵巢超声提示多囊样改变。结论:青春期多囊卵巢综合征的特征为肥胖,月经初潮提前及持续月经不调,存在胰岛素抵抗,卵巢多囊性增大。

Objective：To investigate the character of reproductive endocrine and metabolic abnormalities in adolescent girls with polycystic ovary syndrome（PCOS）.Methods：87 adolescent girls with PCOS were selected as PCOS group.52 girls with BMI≥25 kg/m2,or WHR≥0.85 were divided into obese group（OB-PCOS） and the other 35 cases were selected as non-obese group（NOB-PCOS）.A total of 102 adolescent girls with normal menstruation were selected,22 obese（OB-CON） and 80 non-obese（NOB-CON）.T,LH,PRL,LH/FSH,HOMA-IR,FBG,TG,TC,BMI and WHR were observed and menstrual history was recorded.Results：Menarche age was significantly earlier in adolescent PCOS（12.0±1.5） years than that in control group（13.0±1.3） years.The incidence of obesity was significantly higher in PCOS group than that in control group（P〈0.01）.T,LH,LH/FSH,FINS,HOMA-IR,TG,TC,BMI and WHR were significantly higher in PCOS group than those in control group（P〈0.01）,and those in OB-PCOS were significantly higher than those in NOB-PCOS（P〈0.05）.96.3%PCOS girls presented with an ultrasonic morphological evidence of polycystic ovarian.Conclusion：The features of adolescent PCOS are obesity,earlier onset of menarche and persistent menstrual disorder,insulin resistance,polycystic ovarian.